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kidney inflammation
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kidney inflammation

i did a urine test recently and the results showed that there were traces of blood .

The result showed 3-5 in range (/hpf) and <3 in ref.range.

I do not know what does it mean.

However, when I see the doctor, he said that it might be due to inflammation of the kidney and he said it might be due to some fever when I was young or other things that cause it. But, he told me not to worry and nothing was wrong as I did not experience any pain while passing urine.

Is this true? Will kidney inflammation heal on its own? If not, what should I do?
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Avatar_n_tn
by the way, no crystals or other materials were found in the urine test result, so i doubt it is kidney stones
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Avatar_dr_f_tn
Hi,

The way I understand your urinalysis showed rbc numbering at 3-5 /hpf and the normal reference for your laboratory was less than 3? Is this correct?

Were you able to visibly or grossly note bleeding in your urine?

In other laboratories, urine RBC's numbering up to 5 may still be acceptable. So I feel that in your case, this may be a mild case of microscopic hematuria. In the presence of mild hematuria,other factors have to be noted like bacteria and WBC levels. You have also negative crystals and casts. This may offer some relief.  I suggest that a CT scan of the kidneys ,ureter and bladder be done just to rule out any structural disorders involving the urinary tract. At this point, I do not think there is anything to worry about. A hemogram may also help as this may note the appearance of the red blood cells. RBC appearance and character may suggest the origin of the bleed and if there is underlying kidney disease.

How old are you?

Have you been diagnosed with diabetes?

Any associated symptoms like pain in urination or increase in urinary frequency?

Inflammation and infections may cause hematuria. With this, your fasting blood sugar and blood pressure levels as well urine protein levels should also be determined. Asymptomatic hematuria may be influenced by stress and strenuous exercises. So during a repeat urinalysis ,it is important not to engage in any strenuous activities.
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Avatar_n_tn
I am 21 this year and not diagnosed with diabetes.

From the report I see, the bacteria has a nil result returned.

My WBC level is 0-2 and the ref range given is <6. Therefore, i think WBC is not the cause.

The doc I saw describe to me that the kidney act as a filter which filters all those toxic stuff. And since he said my kidney might be suffering from inflammation, the kidney could not prevent the blood from escaping and he said this should not be the case as RBC are thick and should not pass through the filter. But he told me not to worry.

Any advice?
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Avatar_n_tn
I forget to add that I have no pain nor increase in urine freq.

What is hematuria by the way? You said that my fasting blood sugar and blood pressure levels as well urine protein levels should also be determined? As in the test result that I took should also show this? And I did not engage in any strenuous activities so far.

By the way the test results are as below

Urinalysis                      Result           Ref.Range
Urine Color                    Colorless
Urine Clarity                  Clear

Urine Chemistry
pH                                 6.5                5.0-8.0
Specific Gravity              1.008             1.005-1.030
Nitrite                            Negative         Negative
Protein                          Negative         Negative
Glucose                        Negative         Negative
Ketones                        Negative         Negative
Urobilinogen                  Normal
Bilirubin                        Negative         Negative
Blood                           *TRACE        

Urine Microscopy
White Blood Cells           0-2    (/hpf)      <6    
Red Blood Cells              *3-5   (/hpf)     <3
Epithelial Cells                0-2    (/hpf)    
Muscus Threads             Nil
Bacteria                         Nil     (/hpf)      Nil
Yeast Cells                    Nil     (/hpf)      Nil

Casts                             Nil
Crystals                         Nil
Others                           Nil
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Avatar_dr_f_tn
Hi,

Your urinalysis appears normal except for the slightly elevated red blood cells. Hematuria refers to passing of RBC in the urine. In your case, looking at your urinalysis results does not seem to suggest something urgent. The red blood cell is mildly elevated but all other factors are within normal range .Your protein is negative and there seems to be no underlying infection.

Drink adequate amount of water and engage in mild low impact exercises such as swimming.

You may opt for a repeat urinalysis within a month just to see if the hematuria persists. You may be managed from there.

Do keep us posted with regards to you progress.
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Avatar_n_tn
Hi,

I went to the hospital today to take another urine test because I feel the doctor's comments were doubtful.

They again detected blood and high lvl of sugar in my urine and referred me to a specialist at a later date.

I heard them saying might be early diabetes or some other problem. Is this very grave? Is it preventable/curable?
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Avatar_dr_f_tn
Hi,

Your physicians are thinking of diabetes at this point which may be a likely differential given that urine glucose levels are elevated.

Prior to giving your urine sample, have you engaged in any exercises or took a heavy meal?

At this point, assessment based on the working diagnosis of diabetes is something that has to be pursued. I do not think you have to be very worried about this. Let us wait for the results of your other tests. Has your physician requested for blood tests already? Several factors have to be considered here. Further tests like an ultrasound of the kidneys, ureters and bladder or an abdominal CT scan may help.

Do you have a strong family history of diabetes?



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Avatar_n_tn
Hi,

I have not engaged in any exercises prior to giving the urine sample nor have I had a heavy meal. I took it on an empty stomach.

I have already taken the blood test and it is the blood test that the doctor say I have high lvl of sugar in the blood.

My grandma has diabetes. So what are the chances of me getting it?

And is it preventable/curable if detected at early stage?
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Avatar_dr_f_tn
Hi,

Diabetes is a complex disease and currently there are several types. These are  type 1, type 2 , early onset type 2 DM and MODY. Other forms of insulin resistance conditions may also be caused by autoimmune and genetic factors.

"In all types of diabetes there is a balance between genetic
and environmental factors, but as in other diseases, genes
play a greater role in patients with a younger-onset for
their diabetes. This is clearly seen in Type 2 diabetes.
There is considerable evidence that genes, as well as
major environmental influences like obesity, are important
in the aetiology of Type 2 diabetes. Children and siblings
of patients with Type 2 diabetes, who share 50% of their
genes, are 3–4 times more likely to have Type 2 diabetes
than subjects without diabetic relatives."

Source:http://www.ias.ac.in/currsci/feb102002/273.pdf

A diagnosis of diabetes has to be established. Your blood sugar level should be taken again and see if it is persistently elevated. As you are only 21, other factors like genetic factors and antibody testing may be considered. I do not want to alarm you. These are just differentials and these are just probable diagnosis for your case. I feel that the results of your blood tests may need to be assessed further.
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Avatar_n_tn
In other words I have to wait till my specialist appointment in May before anything can be concluded?

By the way, according to what you say, I assume early diabetes, as in early detection has no cure also ?
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Avatar_dr_f_tn
Hi,


Yes. Diabetes needs to be diagnosed based on blood tests .The urinalysis only suggests the condition but is not the gold standard for diagnosing diabetes.

Diabetes is only a differential here which means it can be one condition that your physician will look into since it may help explain the high sugar levels in your urine. Diabetes and its types do have their respective forms of management. It is not the time of detection but the type of diabetes which influences therapy and management. Early detection of diabetes helps in managing the disease properly.

In a way, your physicians are assuming  diabetes here until this is proven otherwise. In medical terms, diabetes is a “working diagnosis” but this may change after further testing. Your subsequent consults will help establish diagnosis.
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